Efficacy, Safety of Solution Containing Hyperosmolar Sodium Lactate Infusion for Resuscitation of Patients With Hemorrhagic Shock
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Purpose
Indication: Resuscitation in pts with hemorrhagic shock due to multiple injuries
Prospective, open label RCT in pts. with traumatic hemorrhagic shock in RS Hasan Sadikin Hospital, Indonesia.
PI: Dr. Kiki Lukman, PsBD(K), Surgery, RSHS. Co-PI: (late)Prof. Xavier Leverve MD, PhD, Directeur, INSERM-E0221-Bioenergetique Fondamentale et Appliquée Université Joseph Fourier, France
Hemorrhagic shock is a cause of death in trauma.Fluid resuscitation to ensure stable hemodynamics and microcirculation by rapidly restoring circulating plasma volume could be a cornerstone of managing trauma patients. Excessive fluid accumulation particularly in the interstitial tissue should be avoided. Hypertonic solution shows promise in restoring intravascular volume expansion and microcirculation with less fluid infusion in hypovolemic patients. This study investigated efficacy and safety of hyperosmolar Na lactate(Totilac®) for resuscitating traumatic hemorrhagic shock patients.
Patients with multiple injuries with grade III hemorrhagic shock and RTS ≥4 received std initial fluid resuscitation of upto 2 liters of isotonic crystalloid. They also got similar dose of either hyperosmolar Na lactate or ringer's lactate. Hemodynamic status, fluid balance and and safety was recorded during the study.
| Condition | Intervention | Phase |
|---|---|---|
|
Hemorrhagic Shock |
Drug: Hyperosmolar sodium lactate Drug: Ringer's lactate |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | The Clinical Efficacy and Safety of a Proprietary Solution Containing Hypertonic Sodium Lactate (Totilac®) Infusion for Resuscitation of Patients With Hemorrhagic Shock Due to Multiple Injuries |
- Urinary output (UOP) [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Blood pressure [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Mean arterial pressure [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Heart rate [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Respiration rate [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Glasgow coma scale value [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
- Fluid balance [ Time Frame: 3 hours ] [ Designated as safety issue: Yes ]
| Enrollment: | 71 |
| Study Start Date: | July 2009 |
| Study Completion Date: | January 2011 |
| Primary Completion Date: | January 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Totilac |
Drug: Hyperosmolar sodium lactate
1st loading : Upto 2 liters of Ringer's lactate, followed by Totilac which was given 5 mL/kgBW/15 minutes, followed by maintenance 2 mL/kgBW/hour for 3 hours
Other Name: Kalsolac
|
| Active Comparator: Ringer's lactate |
Drug: Ringer's lactate
1st loading : Upto 2 litres of Ringer's lactate, followed by 5 mL/kgBW/15 minutes,followed by maintenance : 2 mL/kgBW/hour for 3 hours
Other Name: Lactated Ringer's solution
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female, aged 18-65 years
- Patients with grade III hemorrhagic shock (who fulfilled at least 2 of these following criteria: 1.5-2 L blood loss estimation, MAP <65 mmHg, pulse pressure <20 mmHg, heart rate >120 times/min, respiratory rate 30-40 times/min or urinary output 5-15 ml/hour) due to multiple injuries (simultaneously injuries in two or more organs of the body)
- Survival probability is >50%, predicted by Revised Trauma Score ≥ 4 (scale 0-7.8408)
- Given written informed consent
Exclusion Criteria:
- Patients with burns >20% of body surface area
- Patients with Glasgow Coma Score ≤ 13 (moderate and severe head injury)
- Patients with systemic diseases which were already present before having trauma, such as: cancer, chronic renal failure, liver failure, decompensated heart failure, AIDS (CD4<200/uL) or HIV serology positive with HAAR
- Hemorrhagic shock patients with trias sign: coagulopathy, acidosis and hypothermia that needs blood transfusion immediately
- Patients who were pregnant before having trauma
Contacts and Locations| Indonesia | |
| Department of Surgery, Dr. Hasan Sadikin Hospital | |
| Bandung, Indonesia | |
| Principal Investigator: | Kiki Lukman, SpBD(K) | Department of Surgery, Dr. Hasan Sadikin Hospital, Bandung, Indonesia |
More Information
No publications provided
| Responsible Party: | Dr Rikrik Ilyas, Director, Innogene Kalbiotech Pte. Ltd. |
| ClinicalTrials.gov Identifier: | NCT01433276 History of Changes |
| Other Study ID Numbers: | 009/IGK-KAL/09 |
| Study First Received: | August 10, 2011 |
| Last Updated: | September 12, 2011 |
| Health Authority: | Indonesia: National Agency of Drug and Food Control |
Keywords provided by Innogene Kalbiotech Pte. Ltd:
|
Fluid resuscitation hemorrhagic shock Totilac Ringer's trauma |
Additional relevant MeSH terms:
|
Shock Shock, Hemorrhagic Pathologic Processes Hemorrhage |
ClinicalTrials.gov processed this record on June 18, 2013